Sterilization & surgical pack prep Flashcards
what is antiseptic
antimicrobial used on skin
What is disinfectant?
antimicrobial used on inanimate object
Critical medical item
- all devices used or placed via incision puncture
ex: surgical instruments, catheters, orthopedic inplants
Semicritical medical item
devices that enters epithelium-lined lumen
ex: laryngoscopes, ET tube, flexible endoscope
noncritical medical item
hospital surfaces, external-applied devices
What sterilization is effective in the presence of gross organinc debris?
no sterilization or disinfectant
Radiation sterilization
- use ionizing radiation
- primarily industrial use
- low-temp
What are radiation sterilization usually used on?
most disposable surgical supplies & some inplants
Steam sterilization through autoclave
- coagulation & denaturation of cellular protein
- high- temperature, pressurized steam
- requires set duration
- requires drying
- reliable, non-toxic
- cannot sterilize heat liable items
What happens when steam sterilization temperature increases?
time required decreases
What are required during heat sterilization?
- require exposure for set duration
- drying time
- careful wrapping, loading of packs
- PPE to avoid thermal burns
What is gravity dependent autoclave?
- most common
- steam enters from top & displace air through valve
- temperature sensitive valve closes as steam enters
- vacuum-dependent
What is vacuum dependent autoclave?
- air removed prior to injection of steam
- steam exposure time shorter
- more expensive
What is “flash autoclave”?
- type of autoclave use
- single instrument unwrapped or single wrapped
- placed on perforated metal tray
- item transferred directly to surgical suit
- emergency use only
What is ethylene oxide sterilization?
- flammable, explosive toxic gas that alkylates microbial proteins, DNA, RNA
- suitable for heat liable items
- requires ventilation & purging of ethylene oxide outside
What to be mindful about when sterilizing with ethylene oxide?
toxic residue in combination with organic material
What is plasma sterilization?
- H2O2 gas + UV radiation
- plasma forms free radicals and oxidizes microbes
- suitable for heat-liable items
- shorter cycles
- but can be unsuitable for linen, cotton, paper, plastics…etc
What is cold sterilization?
- instruments stored in high level disinfectant liquid (glutaraldehyde
- safe for instruments
- not truely sterilization
- need to be rinsed thoroughly (can be toxic to tissues)
What can cause failure of sterilization?
- failure to clean instruments properly
- failure to wrap pack
- failure to load chambers properly
- failure to use equipment properly
- mechanical failure of equipment
What should be done to prevent sterilization failure?
- personnel must be properly trained
- equipment properly maintained
- indicators assist in monitoring of sterilization
Chemical sterilization indicator
- paper strip or tape with material that changes colour
- colour change when exposed to condition
- only confirm exposure to condition
What does chemical sterilization not confirm?
duration of exposure to the condition
What are the benefits of using biological sterilization indicators?
- most reliable
- confirms sterility
What are the characteristics of biological sterilization indicators?
- consist of viable spore-forming bacteria (self-contained for biosafety)
- color change if culture +
- positive test indicated failure of sterilization
- more expensive than chemical indicator
Characteristics of Cotton muslin as pack wrapping material
- can be sterilized via steam & ethylene oxide
- soft, reuseable, durable & inexpensive
- generates lint
- porous to bacteria
- requires double layers
What reduces pores of cotton muslin wrapping material?
higher thread count = less porous
How to make cotton muslin wrapping material less water absorbant?
addition of coating can decrease absorbancy
- coating can wash off
Paper as pack wrapping material
- can sterilize with steam & ethylene oxide
- inexpensive
- non-woven (serves as barrier against bacteria)
- disposable
- fragile
- has memory
- requires double wrapping
Polypropylene fabric as wrapping material
- sterilize with steam & ethylene oxide
- composed of 3 layers
- highly effective bacterial barrier
- water resistant
- durable
- environmental impact (plastic derivative, disposable)
- double-wrap
Heat-sealed pouch as wrapping material
- 2 types: paper/ mylar & Tyvek/mylar
- sterilized with ethylene oxide & steam (paper/ mylar); plasma (Tyvek/mylar)
- convenient
- long shelf life
- water resistant
- single-used
- opened carefully to prevent contamination
Sterile container system
- steam-compatible only
- good storage
- durable & environmentally friendly
- high start-up cost
- has disposable or permanent filters
What is the goal for wrapping packs?
pack easily unwrapped without breaking sterility
What to do with packs after sterilization?
- rack-dry without stacking
- avoid condensation to prevent strikethrough
What is strikethrough?
moisture penetrating porous material
What to do once packs are fully dried?
- label with date sterilized, expiration, initials & lot number
- store in waterproof dust cover
- protect from bending/ crushing…etc
Ideal storage condition for sterilized packs
- controlled room temp
- low humidity
- low air turbulence (away fromo HVAC)
- closed cabinet
- avoid stacking
When to assume loss of sterility?
- moisture/ strikethrough
- damaged package
- dust
Recommended expiration dates for cloth
- 4 weeks
- with water-proof cover: 8 weeks
Recommended expiration date for paper/ polypropylene
6 months
Recommended expiration dates modifications are dependent on?
storage conditions & handling
Rules for pouring sterile fluid into basin?
- pour without touching container basin
- fluid arcs into basin
- do not splash
- do not use the last 100 mL of fluid in bottle
